Dems Make a Health Care Offer That the GOP Can Easily Refuse

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In an improbable twist, all 48 Senate Democrats signed a letter on Tuesday offering to work with the Republican majority to produce a bipartisan overhaul of the Affordable Care Act if the GOP leadership agreed to drop efforts to repeal and replace the landmark legislation.

"Democrats stand ready — as we always have — to develop legislation with Republicans that will improve quality, lower costs, and expand coverage for all Americans,” the Democrats wrote. “But Republicans need to set aside their current partisan efforts and work with us to get this done.”

The offer, revealed by Senate Minority Leader Chuck Schumer (D-NY) and other leaders, is unlikely to go anywhere.

The House last week narrowly passed the highly controversial American Health Care Act which was virtually dictated by the conservative wing of the party. Now Senate leaders are setting aside the House-passed plan and drafting a substitute proposal that is more likely to appeal to the chamber’s more moderate Republican rank and file.

A 13-member steering committee handpicked by Senate Majority Leader Mitch McConnell of Kentucky has begun working behind closed doors to draft the substitute plan. And while Senate Republicans insist they are in no hurry to complete the task, Finance Committee Chair Orrin Hatch (R-UT) said today that whatever finally emerges from the GOP task force will be sent directly to the floor, bypassing committee hearings where Democrats might be expected to speak up.

The Senate Finance and Health, Education, Labor, and Pensions Committees technically have jurisdiction over the health insurance legislation and typically would play a major role in conducting hearings and drafting language for the bill.

But McConnell, Senate Majority Whip John Cornyn of Texas and other top leaders appear determined to keep a tight rein on the deliberations, in search of an approach that keeps Senate GOP defections to a bare minimum while appealing to House Republicans and President Donald Trump.

It’s unlikely that there is any room in McConnell’s calculations for involvement by the Democrats who were united in opposing the House-passed bill and until now appeared willing to continue standing on the sidelines.

The Republicans hold a slim 52-48 seat majority in the Senate. They are using arcane “budget reconciliation” rules that will enable them to approve new health care legislation by a simple 51-vote majority, instead of with the standard 60-vote super majority needed to pass major legislation in the chamber.

However, even mustering a simple majority will not be an easy task, largely because of a half dozen or so moderates and conservatives who have staked out strong positions on a broad array of issues, including the future of expanded Medicaid, and potentially could block the Senate from passing new legislation.

It appears out of the question that Senate Republicans would abruptly change directions and consider a bipartisan approach, especially since House conservatives would go ballistic and Trump is publicly committed to the House-passed version, with perhaps a few improvements.

Yet the Democratic offer is tantalizing because it suggests for the first time that the two sides might be able to strike a deal on a “grand bargain” of health care reforms that would lower premiums and out-of-pocket costs, stabilize the individual insurance market and even reduce the cost of prescription drugs.

What’s more, if Republicans and Democrats worked together to forge a major overhaul of Obamacare, they could muster the 60-vote supermajority to overcome a filibuster. That would obviate the need to use the special reconciliation rules that are complicated and frequently prompt parliamentary challenges.

"The Senate Finance and HELP committees cannot abdicate our responsibility to hold public hearings on such sweeping health reform legislation," the Democrats wrote, according to The Hill.

"Rather than continuing to work in secret, we urge you to make good on your stated preference and long successful history of bipartisan legislating, and hold public hearings on the devastating impact of TrumpCare."

Washington Editor and D.C. Bureau Chief Eric Pianin is a veteran journalist who has covered the federal government, congressional budget and tax issues, and national politics. He spent over 25 years at The Washington Post.